Integrated Healthcare Association pilots new Provider Directory Utility

On June 19th, the Integrated Healthcare Association (IHA) discussed the pilot of the new Provider Directory Utility (PDU) in a webinar presented by the California Medical Association. The PDU is a state-wide, centralized shared information and compliance platform for providers and health plans that will serve as a single source for provider directory data. The PDU is designed to help providers and plans meet the regulatory and business reporting requirements of SB 137 and thus, lower the administrative burden on plans and providers.

Michelle Lewis of IHA explained that with the PDU, IHA and its technology partners Gaine Healthcare and Availity, have teamed to address the major industry challenge of plan/provider data inaccuracies. The PDU will support efficient data exchange by collecting data from plans and providers with minimal input, verifying data, and facilitating efficient distribution and access.

 

Rajan Shah, the Vice President of Business Development for Gaine, iterated three key points regarding the project:

  • There is currently no place that coordinates providers’ contractual commitments causing confusing and duplicative effort.
  • PDU partners are focused on ensuring data privacy though high level data security and a transparent and visible collection process.
  • Vendors are seeking to establish critical mass for adoption by targeting the right contacts and ensuring the proper specificity of information.

A soft rollout of the PDU is set to begin later this summer with the participation of the three largest network plans in California, Blue Shield of California, Anthem Blue Cross, and Health Net. The smaller scale rollout will be a chance for the PDU team to test the technology and collaborate with plans and providers about the features and how to best refine the functionality of the platform before the more public launch in 2019. Shah explained the project targeted these larger plans for the pilot in hopes of reaching a large existing market that will speed the more universal adoption of the PDU in the public launch.

Michelle Lewis explained that the project is currently funded a grant negotiated in the 2015 acquisition of Care 1st by Blue Shield, but is planned to become a “self-sufficient utility.”

“We are working to make it [the PDU] self-sustaining. There will be a cost to participate, but we are aiming not to let that be a barrier to participation.”

Lewis specified that the PDU is designed for public managed care plans like Covered California, as well as private plans like those participating in the pilot. IHA will be continuing outreach to providers and plans throughout the end of the year in preparation for the PDU’s public roll-out in 2019. Interested parties can check here for more information.